The Doctor's Consultation: When bleeding can be a real pain in the bottom!
Bleeding from any orifice should not be taken lightly. It
is not normal to cough up blood, spit up blood, bleed from the nose or ear
canal, or bleed from the anus. It means ‘something’ is wrong. Generally
the ‘something’ is minor, but it may be the symptoms of an invading
This is why the specific cause of any rectal bleeding must
be identified so appropriate treatment can be started and the problem
corrected. Even though most cases of rectal bleeding are not serious, you
should never ignore this warning symptom, no matter how embarrassed you may be
about showing your bottom to the doctor!
There are many causes of rectal bleeding. One of the most
common is Hemorrhoids. These are dilated blood vessels in the anal or rectal
area. Think of them as varicose veins, similar to those you can get in the
legs. They can occur on the outside where they are felt as small grapes when
wiping, but internally they are generally painless, and you do not know they
are there until one bursts and you bleed.
Another cause is a Fistula. This is an abnormal, burrowing
channel that usually runs from the rectum to the skin around the anus. While
it is usually just a local problem, a fistula can be associated with chronic
inflammation in other parts of the intestinal tract such as Crohn’s disease.
Fissures are tears of the anal lining. Nerve endings and
blood vessels are exposed so that pain and bleeding may occur with bowel
Diverticulosis (comes from the Latin ‘diverticulum’
which is translated as a wayside inn of ill repute). Pockets or sacs (called
diverticulae) project from the bowel wall and occasionally they can bleed.
Other conditions such as Proctitis and Colitis can produce bleeding from
inflamed ulcerated tissues.
The big worry is Polyps and Cancer, as they do not produce
symptoms in the early stages. Polyps are growths in the colon, and when they
enlarge, they can bleed. Some polyps can also turn into cancer and the
ulceration of the polyp produces bleeding as well.
Rectal Prolapse. This is commoner in older people, who have
weakened rectal support tissues. Part of the rectum then can project from the
anus and bleed. It can be felt as an abnormal bulging from the rectum when
wiping and needs surgery.
With so many probable causes, how do we make the diagnosis?
The simple answer is by history and examination, which is not only visual. The
old adage is “If you don’t put your finger in it, you will put your foot
in it” (also used regarding prostate examinations).
We will need to know if blood drips into the toilet after a
bowel movement? Bleeding hemorrhoids may be the problem. The color and
frequency of the bleeding are additional considerations. In most cases, the
medical history provides diagnostic clues, but never the final answer.
Inspection (visually and digitally) of the anal area will
reveal tears and hemorrhoids. The DRE (Digital Rectal Examination) can provide
information when there is tenderness or a locally growing tumor inside the
To look further up the anal canal to check for bleeding, a
Sigmoidoscope may be used, but to get even further up inside the colon, a
Colonoscope will be required.
Other procedures can include a Barium Enema X-ray where
liquid barium is inserted by enema into the rectum. This can highlight
abnormal shadows, such as tumors, diverticulae and colitis.
So while the causes may be several, the tre atment for most is not major.
However, as I mentioned at the beginning of this week’s article, bleeding,
from any orifice, should not be ignored.
(Sorry for sounding so ‘familiar’ but that’s the effect you have on
most of us readers, Petal) Though it’s kind of
refreshing to read that David (Sat, 24th Dec) hasn’t adopted the, all
too familiar, down-trodden, condemned man, jaded mindset of so many
Farang-in-Thailand (yet, at least), I have to confess that his opinion
seems somewhat naive. Before I continue, I’d like to wish him good luck
in all he does and I really hope his future experiences don’t lead him
to change his views on Thai people.
For my part, I guess I’m in between somewhere. I’ve had good and bad
experiences here (the good out-weighing the bad). I’m neither jaded
by’, nor patriotic of’ these people. Like he said, “there’s good
and bad everywhere”. I’m not old (36), not big-bellied (though working
on it) but, I am bald! (By choice, you understand – something to do with
excessive U-turns beneath the sheets.)
David mentioned that the key to living a good life out here, was finding
the right woman…. Dear-oh-dear, if one puts so much onus on that, surely
one’s mental state could be severely disturbed if the relationship
doesn’t work out. Moreover, I believe that one should like being here
for much more than ‘a girl/woman’! Sadly, it sounds like David has
‘reacted’ to stories/comments he’s heard, and very obviously has
taken it all personally. What I can’t figure out, is where has he
experienced such condemnation for Thai girls? Boom-boom bars?? Teacher’s
library??? The hotel lobby???? For the way he should really react, is to
question these individuals as to where they generally look for their
future girlfriend/wife? This can usually explain the
haphazard/un-advantageous origins that lead to a certain person’s
disappointment/heart-break. David, David, David….. In my experience,
those young, good-looking Farang (or otherwise) that seem so
‘Pro-Thai’ at first, usually end up being the most jaded of all.
Invest as much as you wish into others but always have a reserve for
yourself. Who knows what the future holds, “same as in Europe”.
My last point. “act as you do in your homeland”. I’ve been preaching
the opposite for years now. I’d hate to see these people corrupted to
the extent that we are. David, this is not Europe! These people are not
Europeans and they never will be. The message should read “acquaint
yourself with the different customs/culture of other Nations”. I’ve
often wondered why heavily-cultured countries don’t have some form of
information leaflet for foreigners, on arrival. Just a little intro on dos
and don’ts….The mind boggles!
I can’t promise you chocolates, Hills, as I’ve a fondness of them
myself, but feel free to ask for my comments on future articles.
Chiang Mai Scooby
How wonderful it is to be 36 and have the answers to all the world’s
ills (not Hills). But how traumatic it must be when people don’t listen,
or give a damn, and run headlong into the mire, yet again. I am however
also very worried about your tonsorial problem. Perhaps if you got the
laundry to use a double shot of softener in the final rinse, that might
help take the roughness out of the sheets. Ot perhaps change them more
often? I don’t know that I can agree with your final paragraph, Petal.
My experiences are that many Europeans forget their Euro-style manners and
turn into bellicose boors, and believe that money buys everything in this
country. It may buy some (doubtful) companionship, but it certainly
doesn’t buy a life’s partner (unless you are having a short life). As
far as acquainting themselves by reading leaflets, that’s not necessary.
Just keep reading my column!
I have a really terrible problem and it seems to be getting worse
every day. When I go outside of my room I keep meeting people wearing
t-shirts with Von Dutch on it, in a funny writing style. Then I began to
notice that everyone has one these days. Women have handbags with it
written on it as well. Everywhere I go it’s Von Dutch. First I don’t
know what it means, and second I don’t have one piece of clothes with it
written on it. What should I do Hillary? Go and buy one at the Von Dutch
store (but I don’t know where that is), buy a copy, or stay indoors
until this fad is over?
Dear Von Not Dutch,
You certainly have got a problem, my Petal. How could you even possibly
think of going outside without a Von Dutch T-shirt? Goodness me, I put on
my Von Dutch dress, Von Dutch sunglasses, Von Dutch scarf and Von Dutch
shoes before going into the lounge room after I have my bath in the
morning, let alone going shopping outside the house! In fact, to admit you
haven’t got one Von Dutch item of apparel, is almost as bad as telling
people that you have leprosy or some other nasty diseases. So please trot
down to the copy T-shirt shop and get yourself a Von Dutch straight away.
You might be able to trade in last year’s Tommy Tommy Hilfiger on it. (I
still think it was very mean of his parents to give him a middle name the
same as his first name, but then I have never really understood
Camera Class: Give yourself a theme – and improve on it!
by Harry Flashman
There is so much more to photography than just taking photographs of
relatives, loved ones and where you went for your holidays, and if you want to
improve your photography, there is no better way than giving yourself a photo
project. Simply, an exercise for the mind becomes an exercise in photographic
When you think about it, this is how the professional
photojournalists work. National Geographic (or even this newspaper!) tells their
photographers to go out and cover the opening of a restaurant, the closing of an
airport or a day in the life of the Amazonian frogs. However, in your case, the
best thing about your self-directed projects is that you get to choose the
subject, so you do not need to go to South America!
Actually, this is one of the reasons Harry Flashman became a
professional photographer. I gave myself the task of illustrating a “book”
as if I had been given the assignment. As I worked on it, I could see the
photographic techniques I had to master, and the “book” became more of a
self-teaching exercise for young photographers. In fact it was one shot from
that exercise resulted in the first commercial contract. It was the start of a
new career, so your own photo project could be the start of your new career.
Of course, you don’t need to be setting out on a new career
path, you can do this exercise at any time in your life, and what better time to
start than at the start of 2006? So what should you choose as the subject of
this project? As they say in Thailand, “Up to you!” However, here are a few
ideas. I have a personal one which is a photo-record of the busses in Thailand.
Since this country is the ‘Bus capital of the universe’ (my working title),
I have been photographing the wonderfully colorful busses. Size becomes the
technical difficulty, because it can be difficult to get far enough away from a
bus to be able to get it all in the frame, and then you are too far away to see
the details. So to record one bus, you need an overall shot, and then close-ups,
but to include parts of the bus each time, to show that this art work really was
on the side of a bus.
One of my photographic friends, Ernie Kuehnelt, who is more
at the retiral end of life than at the beginning so he doesn’t need a new
career, came up with his own project a couple of years ago – he is
photographing people on motorcycles. You know the sort of things – families of
five on one motorbike, little kids hanging onto the rear view mirrors, girls
riding side saddle, small fluffy dogs in the carrier in the front, motorcycle
taxi riders popping pimples in the rear vision mirror. This project is endless
and I’m sure Ernie doesn’t mind if you try to illustrate this one yourself.
After starting his project he realized he was not getting
close enough to the action, so decided to use a telephoto lens and see what
results he gets from that. He had already found he needed to get a reasonably
high vantage point, or the motorcycles got lost in the sea of motor cars. As I
said at the beginning of this article, “an exercise for the mind becomes an
exercise in photographic technique” and you will soon appreciate this.
An important part of this exercise is to pick a theme that
appeals to you, not trying to work out what kind of shots you want to take. So
if your great passion in life is Japanese food, then start there and eat your
way through your project! Once you have the project, the excitement of actually
bringing it to life will spur you on to greater understanding, and incidentally,
Cats - the individualistic feline: Oriental Shorthair and Longhair Cats
We are Siamese if you please
Linda L. Galloway
The Oriental cat was first developed from the Siamese to
explore all possibilities of coat color and pattern. Imagine a Siamese
wearing head to toe a satin coat of every color and pattern imaginable and
you have an Oriental Shorthair (OSH).
When the OSH was accepted for Championship status in
1977, it became one of America’s most popular breeds in the Cat
Fanciers’ of America (CFA) registry. Now there are over 300
colors/patterns to choose from, and each color has is special purr-sonality
attributes. Solids, or for a sparkling undercoat stir in the silver gene
at the roots or tips, paint splashes of cream and you have a parti-color. If
like stripes, try tabbies in any of four different patterns: classic,
mackerel, spotted, ticked. Torties with a sprinkling of red and cream on a
background of seal, blue, chocolate or lilac, create a clown-like appearance
and their nature is the equivalent of the “dizzy blond”, as if in the
mix-up of colors they can’t make up their minds about how to behave. If
Lucille Ball was ever reincarnated as a cat, she would definitely be a
OSHs are a study in sleek design from the tip of the long
pointy nose to the end of the long whippy tail. The lines of the angular
head flow into large flaring ears, and are complemented by almond shaped
green (or sometimes golden) eyes. This elegant cat gracefully glides across
the room on tall slender legs. Don’t be fooled by their svelte tubular
body. These cats have surprising weight and muscle tone and are nei
ther frail nor fragile.
The Oriental Longhair (OLH) was the next step in a
natural progression. Breeders of Balinese and Javanese cats (the longhair
versions of the Siamese, see Part 1), who liked the assortment of colors
offered by the OSH breed decided to create a longhair version. The first
documented litter born in 1983 was bred/owned by Billie Cobden (Houston,
Texas). Still a relatively new breed, the OLH was accepted for registration
in 1988 and advanced to Championship status in 1995. They are known as
Angoras in UK and Mandarins in Europe. These fabulous ermine-coated felines
carry the same graceful bodies and silky long coat with plumed tail as their
Bali/Javi counterparts (Part 1). They are elegant, svelte cats that are
playful, spirited, and loyal well beyond their youth. They eagerly greet you
at the door and tell you all about their day. If you’re late, they will
scold you and tell you how worried they were that you didn’t call. Hide on
top of the refrigerator? Wrong! Curiosity and intelligence combine to give
them a means of finding everything and anything. They have been known to
open and empty your purse to discover their favorite toy - a pen or a
crumpled piece of paper they can chase around the floor. Anything to attract
the attention and affection they desperately need. Ignore them and they will
droop with despair.
Longhair or shorthair, Orientals are never aloof. They
are close to the people they claim as their own and desperately want to live
with you. They find their way into every one of your activities: a little
nudge while you eat, a close examination of your toothbrush just before you
use it, helpful hints on which foods to select from the refrigerator. If
you’re a couch potato, they’ll share the warmth of your lap and provide
a comforting purr, or nuzzle your chin when you need it most.
They are true Siamese that came back from living abroad in a coat of many
colors, patterns, and lengths. OSHs are still abundant, but OLHs are now so
rare they are practically an endangered species! Relatively few breeders
around the world now work diligently to keep this breed alive and viable.
Prospective owners are placed on waiting lists for as long as it takes.
These are the breeds that defy what we normally think of as CAT:
independent, aloof, solitary. No way! They couldn’t live without you! For
more information, contact Linda Galloway by email at [email protected]
Dr Byte's Computer Conundrums
by Dr Byte, Citec Asia
Happy New Year everyone. Before I start sharing more
Answers, several people brought their computers to us for repair and they
all shared one common feature. For what ever reason, the Hard Drive had
failed. I am sure you will agree that there’s nothing scarier than the
clicking sound a hard disk makes when it fails. It’s bad enough if you
have recent back-ups, it’s a disaster if you haven’t.
If you haven’t backed up, consider what you’d lose.
You’ll lose your email address list and all the saved emails. Your photo
collection, all the videos of the kids, personal records, the text of the
novel you have half written, all the documents and spreadsheets you have on
your computer, songs you’ve downloaded, the family history you’ve been
recording. The list goes on.
So, how and what to back up? The simplest option is to
back up everything. An alternative is to backup everything in My Documents,
E-mail, your Address Book as well as My Favorites. That usually covers most
things, as long as you keep all your documents under My Documents and not
stores all over the place.
A 20GB hard disk can be backed up to a handful of CDs or
DVDs, or an external back-up device. But if you work from a hard disk with a
capacity of 100 GB or more it is something quite different.
Short of buying a second hard drive to take care of the
risk factor (which is not a bad idea), you will need to determine exactly
what you do need to back up. In short, this should be everything that is
personal to you and that you can’t do without or replace. This is a choice
we individually need to make; what’s vital to me may not be to you.
You can generally avoid backing up programs because
original disks are usually available, however, back up all the programs
downloaded from the web because they are hard and, in some cases, impossible
to locate again.
Consider backing up program set-up files like the
Microsoft Word Normal
.dot file and Outlook Rules so that you will be able to return the programs
to their usual working order later on. These are on my “rainy day”
back-up list, something I’ll do when I get round to it; other things are
more urgent but you have to make that decision for yourself.
When choosing how and where to back up, you have many
options. For software, you can use the program that comes with Windows XP to
back up to an external drive (but not to a DVD or CD). The back-up utility
is automatically installed with Windows XP Professional. If you’re using
Windows Home edition you can install it by placing your original Windows CD
in the drive. Use Windows Explorer to navigate to the \VALUEADD\MSFT
\NTBACKUP folder on the CD and double click the file Ntbackup.msi to run the
wizard that installs the program.
Then Choose Start, All Programs, Accessories, System
Tools, Backup and, when prompted, select “Back up files and settings”
and choose a back-up option such as “Everyone’s documents and
An alternative is to use other software, for example, the
inexpensive Zip Backup can back up to CD or DVD using zip format files and,
if you’re prepared to organise the files to back up manually, you can use
a program capable of burn-ing data DVDs such as Ashampoo Burning Studio 5.
You can also use online back-up sites. These have smaller amounts of space
but are attractive because you’re backing up to an external location and
the information is stored away from your computer. This protects against not
only hard-disk failure but also flood, fire and theft.
Some sites charge for the service and others do not. For
example, Yahoo Briefcase gives Yahoo members a hefty 30MB of free online
storage with an upload limit of 5MB maximum at a time (or 15MB if you
purchase extra space). Other sites such as Xdrive, have up to 5GB for a
monthly fee of about $15 and it’s possible to upload very large files and
entire folders using this service.
To access Yahoo Briefcase, visit au.briefcase .yahoo.com
and type your Yahoo ID and password. You can then create folders and upload
individual files using a simple web interface. The ideal back-up solution is
probably somewhere between DVDs, an external hard drive and an online
In the next column, I have a few more Questions and
Answers to share with you. Don’t forget to keep your preferred anti-virus
and spysweepers up to date. Do a full hard disc scan and sweep at least once
a week. Don’t open e-mails with funny attachments if your not expecting
them and last but not least, make sure your firewall is on. Dr Byte appears
in Chiang Mai Mail every 2 weeks and if you have any questions or
suggestions you would like to make, you can contact me at Dr Byte, Chiangmai
Money Matters: Early winter is here (Part 2)
MBMG International Ltd.
Last week we looked at the fact that the
US government is borrowing over US$ 2 Bn every day, why they’re doing this
and why ultimately this isn’t sustainable. Let’s look at this again in
more detail to dispel some myths and establish what we actually know and
what is merely conjecture.
The amount of government deficit is well in excess of 5%
and rapidly approaching 6% of GDP. This sets off many alarm bells since many
analysts see 6% as a trigger point at which a financial dislocation
(recession, stock market collapse, currency crash) is inevitable. This is
supported by Caroline Freund’s Federal Reserve System International
Finance Discussion paper #692 published 5 years ago which equated this 6%
threshold to the US swallowing 70 – 80% off all world’s savings in order
to continue to fund inflows which have now exceeded 2$ billion dollar per
Some 4 years ago, Dr. Lawrence Lindsey, a former White
House Economic Advisor, warned “I do think it is important that we all
keep this in mind: we have had 20 years of expansion - 18 actually, going on
19. And it has been an extraordinary period. But that does not mean that
everything is AOK ... it is unlikely that we could forever borrow 4% of GDP
from the rest of the world. Or more precisely if you look at trends, we are
borrowing increasing amounts from the rest of the world. Imagine going to
your banker and saying, ‘We thank you very much for the $280 (billion) you
lent us in 1999, and the $400 (billion) you lent us in 2000, and it looks
like this year it is going to come in about $520 (billion). We are going to
need $650 (billion) in additional cash in ’02, probably $800 (billion) in
’03.’ Getting the picture? This is otherwise known as ‘evergreen’
financing. And it won’t work. At some point, it is going to have to be
adjusted.” (Back then it was only 4% but Lindsey could see that the Bush
administration policies were determined to keep increasing the borrowing
This view is supported by former Fed Chairman Paul
Volcker, who says: “Below the favourable surface, there are as dangerous
and intractable circumstances as I can remember. We are consuming… about
six percent more than we are producing. What holds the world together is a
massive flow of capital from abroad… it’s what feeds our consumption
binge... the United States economy is growing on the savings of the poor…
A big adjustment will inevitably become necessary, long before the social
security surpluses disappear and the deficit explodes... We are skating on
increasingly thin ice.”
The closest economic advisor of Australian Treasurer,
Peter Costello, fears that the US is heading for a devastating financial
crash which would involve a sharp fall in the US dollar and a bond and
equity market sell off.
A dissenting Federal Reserve System International Finance
Discussion Paper Number 827 penned by Hilary Croke, Steven B. Kamin and
Sylvain Leduc has suggested that such a level of deficit in the US
wouldn’t necessarily cause a major dislocation by looking at the working
out if current account adjustments in countries such as Ireland, Greece,
Belgium, Portugal, New Zealand, Austria, Norway and Spain.
We have produced a critique of this paper which is
available upon request and in fact we asked the authors why their study
apparently failed to apply any real critical qualitative criteria to the
comparators chosen (i.e. why they could present a Greek national debt of 15
years ago as being comparable with that in the US today). If nothing else,
we couldn’t understand why the obvious parallel of USA 1929 hadn’t been
On behalf of the joint authors Steve Kamin replied:
“Aside from focusing on industrial economies (and thus excluding
developing economies), we applied no further criteria to our selection of
economies. The reason for this, simply, is that it was not obvious what
further criteria should be applied. We focused on episodes since 1980
primarily because of data availability, but also because, arguably, with the
increasing integration of international product and financial markets, the
more recent experience of adjustment episodes might have more relevance to
the future than earlier episodes.”
In other words, they’re guessing, assuming, and working
at the level of the immediately obvious. To us, this seems seriously flawed.
Armed with this flawed research Alan Greenspan told a European bankers
conference in Frankfurt that, “Current account deficits, even large ones,
have been defused without significant consequences, (but) we cannot become
When you see all this, the question has to be asked about American
policy, how on earth can you rely on a Gaelic Greco-Iberian financial model
for American and global economic salvation?
The above data and research was compiled from sources
believed to be reliable. However, neither MBMG International Ltd nor its
officers can accept any liability for any errors or omissions in the above
article nor bear any responsibility for any losses achieved as a result of
any actions taken or not taken as a consequence of reading the above
article. For more information please contact Alan Hall on
Life in the Laugh Lane: Let Go
by Scott Jones
Tired of pushing my aged Kawasaki bikes or
visiting them in garage intensive care units strewn with their body parts, I
bought a newer, common, reliable Honda Super 4 with low mileage: 8522 km. By
the time I’d ridden it from Bangkok to Ranong, some 500 miles, the
speedometer read 8523. Do the math. It appears my “newer” bike may have
4,261,500 actual kilometers. Hey, it starts, runs and stops. Who cares how
second busiest road in paradise
The dream was a ride to paradise on Koh Phayam. Lonely
Planet says: “no
cars or trucks and roads are pleasantly motorcycle-sized.” Unfortunately
there’s no ferry and no one knows much about transporting a big bike, though
our bungalow owner says, “No problem. We take you. 2,500 baht, round trip.”
(Translation: “Stupid Farang. Give me your money. I take you to the moon.”)
As the captain is summoned I imagine planks from the shore to the small
long-tail and the crowds of people required on both ends of the trip to get the
bike on and off, most likely drunken midgets with slippery hands staggering out
of a tavern. Mr. Captain arrives and instills no confidence by saying, “It
might fall into sea.” We choose to take our chances in town. On the map, the
sea looks very calm and the island is only two centimeters off the shore.
Unfortunately, the path to our “ferry” can barely be traversed by foot over
a greasy, jellyfish-laden platform, then down two meters onto a squid boat,
then down another meter to a modern speed boat driven by a prehistoric man. I
might as well have ridden the bike off the pier.
The message: Let go of the bike. I leave it with the ticket
taker after his police buddies with big, official grins assure me he is a
“good man.” When I return, there will probably be a new ticket taker and a
new mobile Honda parts store in town advertising “Moving Sale!” Had the
bike made it onto the boat, it wouldn’t have been there long and undoubtedly
would have killed the crew. Several times during the ride, the passengers are
suspended above the boat and the boat above the sea before crashing down into
leftover tsunamis. Koh Phayam’s “motorcycle-sized roads” are littered
with random sand dunes, sleeping dog speed bumps and pot holes large enough to
be tourist attractions with bungalows built around them. The “road” to our
resort degenerates into a jungle trail built by cave men sometime after the
invention of the sled but before the invention of the wheel.
This brings to mind a previous bike/pier experience. After
docking in the Virgin Islands, we rented bicycles for a snorkeling trip to the
beach. The moment the bikes were loaded with gear, I turned to wave goodbye to
my uncle as a gust of wind blew my bike off the pier into the water, two meters
down. Being a dull-witted, quick thinker, I immediately plunged in and grabbed
the bike with one hand and my pack with the other. Soaked clothes, tennis shoes
and no hands free do not make an efficient life guard. As the bike and I slowly
sank into the six meter harbor with the sun fading in the distance and my life
passing in front of my eyes, five vital words flashed
in my mind: Let go of the bike.
Some folks snorkel with brilliant tropical fish and sea creatures. I skin
dive for fins, masks, shirts, sandals and passports half-submerged on the floor
of a murky
harbor composed of decomposing sewage dumped by docked sailboats. I form a
support group for folks with similar traumatic experiences called the Diving
Underwater for Missing Bicycles Association. No one joins, perhaps because of
its acronym: DUMB ASS.